EENT WARD AND CLINIC

One of my friends was asking me about the hospital and as I explained it I thought maybe I should write about it here. Some things I have talked about in other blogs but some will be new. The Hospital is free and funded by the government. Many times drugs and supplies are “NOT THERE” and the patient suffers The hospital sits on a equivalent of a block. There are 14 separate wards of buildings and a morgue. There is a private ward that you can pay to have a private room in a private building I have only visited friends there the students don't go there. It is next to the morgue and physical therapy. All building have metal roofs with a ceiling inside that is about 20 feet up so when it rains some of the noise gets absorbed.

The EENT clinic and hospital is funded by the Lions of Norway and is clean, neat, has a OR in it, and staffed by very knowledgeable people. It is a shiny star at the hospital, and has a light patient load most of the time. They do cataracts and have a Dr of Ophthalmology who comes sometimes. Most of the hosp is staffed by clinical officers. They are 2 or 3 years short of MD but do most of the work. If it is complicated a pt get referred (but can't afford the transportation fee to get to Kampala) or they just give up and go home.

Next is a nice new building for diabetic clinic. Because the society here were very hard workers and big carbohydrate consumers when they get laid up or old they still consume the crabs but aren't doing the physical labor anymore and this is the disease making it's way into society. Many are on oral meds some on insulin but this is hard as continued resources to buy insulin and needles is very hard. Probably why the average age of death is 57. (I have a year to go)

across the street is Arua Hosp AIDS project run by MSF (Medicus San Frontier (DR WITHOUT BORDERS)) It is a clinic for testing, counseling, medication refill, and check ups. Well run.

HOW MANY LEAVE THE WARD

Up the street is Nutrition MSF run again great program with wonderful results but a high return rate. The discharge part of the picture is lacking. Malnutrition is the disease of the 2 child. Reason being baby 1 is born and breast fed, baby 2 comes along in 11-14 months and baby 1 has not been weened or learned to eat independently and goes into shock when new baby is now getting breast and quiets eating so that is why the disease comes when 2^nd baby comes. I am amazed at the sad size of these little ones. Many come with 1 or 2 more diseases along with the malnutrition They are put babes on formula and breast and give feeds ever 3 hours to start and 6 as they get better. When hey go home they are given a peanut butter bar called Plumpy nut that has all the vit and minerals added and the babe is to eat 2 a day. Well mom eats them too or they get sold in the market as the mom is 16 with 2 kids and needs $ for something else and baby gets cassava porridge at home which has no nutrition only carbohydrates in. Limited education, young parenthood, multiple births, no employment for men who are encouraged to have many children (this is your wealth) with up to 4 wives, and then aren't around, keep this disease or condition alive and active here. This week I and a friend are going to the Hospital in Kampala to do a filming of the discharge instructions given to mothers there. Before the mother leaves she must demonstrate how much and how to cook for her malnourished baby using local food. Like adding dried fish to the water you make the cassava portage out of or adding an egg. We are then bringing the tape here, I will have the students watch and re do in the local language and we will film again so the Nutrition ward can show it (when the power is on) on the TV daily we hope. By the time the mom goes home we are hoping she will have heard the message enough times she will remember and implement at home from her garden. For my friends the nutritionists, Lynn and Myrna please pray and email me if you have other suggestions we could do that are cost free for the mom's.

Next is Male Medical which has many young men with liver failure from alcohol abuse, malaria not treated, shisto (a liver parasite from the water) worms, pneumonia, malnourished, a few with congestive heart failure, meningitis, typhoid just to name a few. But majority is alcohol abuse and moringe use (a stimulant that is like crack your brain wants more and more and in a month of chewing the leaves the men are burnt out. The Sudanese and Somalian people use it but they do not have the brain damage that the Ugandan's suffer. This ward is over crowded with people sleeping on the floor on a mat or on a bed with a mattress with the covering so Pee soaked the place stinks. The Nurse in charge is excellent and does well but resources are limited to 2 box's of gloves a week for the ward of about 60 men.

Next is the AHAP maternal child preventing mother to child transmission clinic. If a mom test + for HIV she is monitored here. Her prenatal are done here and when baby is born the midwives follow the mom on the ward and start the baby on the anti retro virals. If the baby continues on them for 6 months and is retested they are often HIV free but the meds are the key and they have some big side effects so baby is monitored at this clinic too. 

The next building is the Maternal Child Health Clinic. It is across the street from the Maternity ward

In this building you get prenatal checkups, cancer screenings, family planning, and well baby checks which are weight and shots. So in Maternity you walk around until you are ready to push, you bring your own mothers kit which is a garbage bag cut in 2, 2 pair of gloves, a ½ straight edge razor to cut the cord (leading cause of tetanus in the newborn) and 3 blankets, a gauze pak and several rags for wiping, a basin and cup for tea if you are out of energy to push the answer is you need highly sugared tea. Seems to work as all the babies come eventually. Anyway, after you have your baby they clean you up give you the babe and you take your mat and lay on the floor in the hallway to recover for 24 hours. If you don't hemorrhage you are discharged to walk across the street and get your baby immunized, then get on a boda (motorcycle) and go home. Hopefully with your aunt or sister or maybe mom if she isn't having her own baby. With 20-30 births a day and ½ the population under 15 the system must work. Maternity ward is under stocked for equipment and supplies and they have a few cats that wander around and sit on the shelves under supplies when a woman is birthing. The culture does not have anyone as birth attendant except the midwife. No male presence here and only female caretakers are let in the ward but not when the work of pushing is happening. She just brings in fresh rags for clean up and the tea. I feel very bad for the moms. To me this is not a pleasant experience, especially if this is baby 1 and you are 15.

The other part of the maternity ward is for C sections, and a ward for cancer, gynecology surgery, child defilement. Place is always busy, not well supplied but pretty clean.

At the end of the road and closest to our main gate and road is the Mental Health Ward. Funded well with a donor from the US who set up a ward for trauma victims after his son was killed in the towers of 9-11. They still do electro shock therapy though (Like in 1 flew over the cuckoo's nest) Main problems treated are epilepsy, depression, alcohol and marijuana addiction, bi polar, dementia, schizophrenia. Trauma counseling is done too as this area had child soliders and war not that long ago. This is too long so I will add to another day. These are the pic of the students working on the wards. If you come to Africa come healthy and stay that way... Bring you anti malarials it is the number 1 killer of kids here.   TIA  MARC